Physicians Plea RE: H1N1 ~ STOP VACCINATING (except the highest risk that is)

[mzmolly]

This bug did not grow well for the vaccine makers. Fine. They tried their best. But the reality is that the complete order for the US is 250 million doses, the original hope was for 150 million of them by early October, the revised expectation was for 40 million with 10-20 million per week after that, and now, near the end of October, we've been delivered under a dozen million and are told that we'll get just under 30 million by the beginning of November and that 10-20 million per week after that. Let assume that that prediction is not another bill of goods ...

"Initial Target Groups" per the CDC were:
"* pregnant women,
* persons who live with or provide care for infants aged <6 months (e.g., parents, siblings, and daycare providers),
* health-care and emergency medical services personnel,§
* persons aged 6 months--24 years, and
* persons aged 25--64 years who have medical conditions that put them at higher risk for influenza-related complications."
That group is 159 million individuals. And we have about 12 million doses right now. We do not have enough to vaccinate them at this point. Not even 10% of them. Try and the highest risk will go without.

So what should be done? Well there are guidelines for "Limited Vaccine Availability":

* pregnant women,
* persons who live with or provide care for infants aged <6 months (e.g., parents, siblings, and daycare providers),
* health-care and emergency medical services personnel who have direct contact with patients or infectious material,
* children aged 6 months--4 years, and
* children and adolescents aged 5--18 years who have medical conditions that put them at higher risk for influenza-related complications."

This higher risk of death from H1N1 infection subset of the five target groups comprises approximately 42 million persons in the United States. Note: that means not healthy kids 5 and over, let alone anyone over 18, even with a risk factor, unless pregnant, or a household contact of a child under 6 months. We don't even have enough to vaccinate all of them right now, not even a third of them, and, at best, won't until mid-November. We really need to prioritize within that group. Even if half decide to decline the vaccine and take their chances with H1N1 instead.

More at link > SWINEFLU.ORG

[Oregone]

1. How about 32 year old women?

32 is the mean age of ICU patients, and 75% of them women?

[mzmolly]

2. Do you have a link to the data

on this? Could it be that many of these women are pregnant?

[Oregone]

3. Young, healthy women hit hardest by H1N1 flu

http://www.timescolonist.com/health/Young+healthy+women+hardest+H1N1/2095793/story.html

Sorry, 67% ICU women, 72% deaths women. Yes, mean age is 32

The population segment most prone to incidences (2 to 25) according to the CDC is not most prone to critical complications. People need to be careful with what they do with data

BTW, I'm not a studied epidemiologist. I have no idea if focusing on those most prone to death or those most prone to get it (and spread it) is the most effective means to stop total net deaths.

[mzmolly]

4. I still wonder if many of the women were pregnant

yet healthy otherwise? I also wonder what data from the US shows?

Interesting info, thanks.

[Oregone]

5. Id imagine it would of cited that instead of citing that 70% were "healthy"

"Only 30 per cent had serious underlying health problems..."

Pregnancy is not mentioned by name in this article, though its normally grouped into conditions that will cause complications

[mzmolly]

6. I don't doubt the data, I've just not seen it confirmed

elsewhere. So, I'd still be interested in learning if they distinguished pregnancy from "healthy" women in the Canadian study.

Here is interesting info from the WHO:

http://id_center.apic.org/cidrap/content/influenza/swineflu/news/oct1609who.html

Known at-risk groups

Of groups with conditions that raise the risk of severe illness, conference participants agreed that three lead the list: pregnant women, especially in the third trimester; children under the age of 2 years, and people with chronic lung disease, including asthma, the WHO reported.

Disadvantaged populations, such as minority groups and indigenous people, also are disproportionately subject to severe disease, the WHO said. The reasons are not clear, but possibilities include lack of access to care and an increased prevalence of conditions like asthma and diabetes.

The statement also noted that obesity—especially morbid obesity—has been present in many of the severe H1N1 cases, but its role remains poorly understood.

[girl gone mad]

7. What about obesity levels?

I've read that adult morbidity has a high correlation to obesity? Something like 90% or more were obese?

[Oregone]

8. "Only 30 per cent had serious underlying health problems"

[girl gone mad]

9. Yes, but 90% were obese.

TLANTA (AP) — Some swine flu cases in America are raising questions about obesity's role in why some people with infections become seriously ill.

A high proportion of those who have gotten severely ill from swine flu have been obese or extremely obese, but health officials have said that might be due to the fact that heavy people tend to have asthma and other conditions that make them more susceptible. Obesity alone has never been seen as a risk factor for seasonal flu.

But in a report released Friday, health officials detailed the cases of 10 Michigan patients who were very sick from swine flu in late May and early June and ended up at a specialized hospital in Ann Arbor. Three of them died.

Nine of the 10 were either obese or extremely obese. Only three of the 10 had other health problems. Two of the three that died had no other health conditions.

http://www.usatoday.com/news/health/2009-07-10-swine-flu_N.htm